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The Undersigned �Iy^ �AR-r �'10b—O�� � Date Approved <br />Hereby applies for permission foC©t�ISTF' - C.n0_f7r5-TC Z!5 1 DI5UJ {Lk- <br />='R J <br />At the following location <br />SKETCH <br />(Work to be done) <br />nf0 SGJ\LE <br />�ROPosE <br />S\DewA <br />DoGwooG <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove same upon notice from the City and to replace all <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />� /�n ���ZZZeee���� <br />Inspector's Signa re%aLC/C.f'/Y / ' y y <br />Date <br />Remarks <br />Call E#tginvering Deft. 253-8813 <br />74 Hours re <br />construction U#ed. <br />" NOTE <br />CHECK WITH WATER <br />DEPT. FOR WATER LINE <br />Lnr..ATIONS BEFORE EXCAVATION <br />HE <br />Variance Required <br />Yes..... __.._..___..... <br />No--__.......... <br />r � <br />i l 1 <br />Signature of Applicant <br />Address <br />%Telephone Number <br />Date <br />$ /✓ <br />Fce <br />DEPT. APPROVALS <br />!/i ; Gtcr,—/7-73 <br />Engineers - <br />V/ <br />Street <br />Communication <br />Traffic <br />7- <br />Planning ''' <br />tZ <br />yL �/7— <br />C 2-10'✓I' <br />PROWDE FOR <br />PROFFER DRAINAGE <br />